By Dr. W. Gifford Jones
March 3, 2004
It's been said that "He or she who treats himself (or herself ) has a fool for a patient". Now we should expand that remark; she who treats herself for vaginal irritation often loses money and also treats the wrong disease. So if they have any Scottish blood, women should think twice before they treat themselves with over-the-counter (OTC) medication.
Anti-fungal vaginal medicine used to be available only by doctor's prescription. But in the mid 1990's these common medications became OTC items. This resulted in huge sales. Last year, according to AC Nielsen Canada's Market Track, over 2,075,000 units of these medications, costing $30,286,705, were sold.
But 20 million dollars of this amount may as well have been poured down the drain. It was the wrong OTC to treat the disease or in some cases no disease.
Dr. Daron Ferris, Professor of Obstetrics and Gynecology at the Medical College of Georgia, headed a research team that studied 95 women with vaginal irritation. They all believed a vaginal yeast infection was the problem and purchased OTC medication.
Gynecologists carried out pelvic examinations and vaginal cultures to determine the diagnoses. The result? Only one-third of these patients had a yeast infection!
The others were suffering from a variety of other vaginal infections such as trichomonas, a common single celled organism that causes discharge and irritation. Others were diagnosed with bacterial vaginosis due to the germ gardenerella. And in 14 percent of women, doctors were unable to detect any vaginal infection at all.
More important, over 10 percent of the women were found to have serious pelvic problems such as diabetic vulvitis or acute salpingitis, an infection of the fallopian tubes that can result in sterility.
Faced with so many errors in diagnosis should yeast medication remain an OTC item? It's a good question to ask when two-thirds of women are making the wrong diagnosis and some cause serious harm to their bodies. But making it difficult to acquire this medication isn't the solution.
One problem is that doctors are not fail safe. Other studies show that physicians also make the wrong diagnosis in 50 percent of cases! Due to such a poor track record women could justifiably conclude "who needs a doctor?"
But how can this happen? Quite easily. Time and time again I see women who have been prescribed yeast drugs for repeated vaginal irritation. But during previous medical office visits not a single pelvic examination was done. Doctors had prescribed medication without determining a diagnosis.
This is Russian roulette with better odds at Monte Carlo. And this situation occurs because today's assembly-line medicine forces the quicker choice of OTC vaginal medication rather than a more time-consuming pelvic exam.
There's another problem. Vaginal irritation, a terribly annoying itch, requires rapid attention. But how long does it take to get a doctor's appointment? Moreover, many infections occur during the weekend when doctors are rarely available. Remove these medications from the OTC list and where do women get immediate help?
So what should women do? In general, symptoms are not much help in pin-pointing the cause since they are similar for all these infections. But if the itching is intense it's more likely to be a yeast infection. It's also safer to reach for an OTC if there's a well documented history of yeast infection.
The primary caution is to see a doctor quickly if the irritation is associated with abdominal pain, fever or a foul discharge.
A change in lifestyle can also help those who suffer from repeated yeast infections. I'll never forget the patient who I could not cure for months. Finally, I asked if she had any animals in her home, and did they ever get into her bed? It was only after intense probing that she admitted teaching her dog a trick. Since she was away all day at work she had taught the dog to urinate in the bathtubs! The dog had a yeast infection.
Taking showers, rather than baths can decrease the risk of recurrent infection. And if a partner has not had a circumcision his penile foreskin may harbour yeast underneath it.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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